Description

SPECIFIC OBJECTIVES FOR THIS COURSE: DAY 1 â€“ DELIRIUM. Diagnostic features, common causes. Causes of persistent delirium. Non-pharmacologic and pharmacologic treatment approaches to the delirious patient. Options to address agitation. OSTEOPOROSIS: DIAGNOSIS, TREATMENT - Differences in the WHO, physiologic, clinical definition. Effects on bone metabolism of aging and those during the post-menopausal period. Limitations of using only the T-score in assessing the risk of fracture. Importance of adequate vitamin D and calcium in treatment. DEMENTIA - PARTS 1 AND 2 - Common causes of dementia and the value of objectifying cognitive performance. Risks and benefits of commonly used drugs to treat dementia. Reasonable medical evaluation of a newly identified patient. Value of caregiver education and support. DAY 2 - ADVANCED NUTRITIONAL ASSESSMENT AND THERAPY â€“ Utilize readily available clinical data to make accurate and comprehensive nutritional assessments. Common vitamin and mineral deficiencies. Therapeutic nutritional approaches for acutely ill, chronically ill, frail patients. Nutritional therapies towards improved wellness. TREATMENT OF CHRONIC PAIN - Adverse effects of NSAIDs . Alterations in the central peripheral nervous system that can lead to chronic pain. ADRs associated with opiate use. VITAMIN B-12 DEFICIENCY - Normal B-12 physiology and pathophysiology of B-12 deficiency and its causes. Use of metabolic markers. Work-up of B-12 deficiency in clinical practice. OSTEOARTHRITIS: DIAGNOSIS AND TREATMENT - Pathophysiology. Typical and atypical clinical features. Treatments and how to integrate them. Distinguish OA symptoms from those of other localized or generalized disorders. DAY 3 - EXERCISE PROGRAM â€“ Relationship between maximal oxygen consumption, aging, functional status. Potential benefits of exercise. Risks of exercise and how to minimize them. Components of an exercise program. APPROACHES TO GERIATRIC INFECTIONS - Atypical presentation of infectious illness . Causes of pneumonia and UTI, antibiotic selection. Considerations in emerging antibiotic resistance. Options in prevention and treatment of antibiotic associated diarrhea. RHEUMATOLOGIC LAB TESTS, RHEUMATOID ARTHRITIS - Impact of aging on the sensitivity and specificity of rheumatologic lab tests. Alterations in the presentation of rheumatoid arthritis . Use of corticosteroids in elderly onset rheumatoid arthritis. Clinical factors that predict progressive and destructive rheumatoid arthritis. ADRs of biologic treatments in RA. SENSIBLE PRESCRIBING PRACTICES - Limits of studies on drug safety and efficacy. Subtle but significant drug side effects . Undesirable prescribing practices and better approaches. DAY 4 - DEPRESSION â€“ Clinical presentations of depressive syndromes . Utility and application of the Geriatric Depression Scale. Relative advantages and disadvantages of the various medications available for treatment. Role of nutritional supplementation and non-pharmacologic treatments in conjunction with medical treatments. MUSCULOSKELETAL EXAM - Maneuvers in the shoulder exam to detect an impingement syndrome and adhesive capsulitis. Causes of swelling and pain in the elbow and maneuvers to distinguish them. Location of pain and the earliest exam changes noted in arthritis of the hip. The most sensitive test to detect effusions of the knee joint. OFFICE ORTHOPEDICS - Common causes of acute low back pain . Symptoms and treatment of spinal stenosis. Common causes of neck pain . CONTEMPORARY ISSUES IN END OF LIFE CARE - Approach to assessment of the whole patient in a hospice setting. Approaches to common physical symptoms in the terminally ill. Cinical care of patients and their families in the last days of life. Dementia as a terminal illness. DAY 5 - POLYMYALGIA RHEUMATICA, GIANT CELL ARTERITIS â€“ Typical symptoms, physical findings, laboratory abnormalities in polymyalgia rheumatica. Prednisone doses as initial treatment of PMR. Typical and atypical presentations of GCA. Appropriate indication and technique for temporal artery biopsy. The most effective treatment and the most serious complications of GCA. RISK MANAGEMENT AND CARE - Principles of effective risk management practices. Medical errors. Benefits of honest disclosure of medical errors. GOUT, PSEUDOGOUT - Unique characteristics of gout . Factors that impact the presentation, treatment of gout. Cinical manifestations of calcium pyrophosphate deposition. Polarized microscopic findings for uric acid and CPPD crystals. IMPROVING COMMUNICATION SKILLS - Ways that people perceive communication and process information. Your personal communication strengths and limitations. Communication issues unique to older patients. Practices to maximize effective communication and listening.